To explore the effectiveness and safety of bortezomib, cyclophosphamide and dexamethasone (BCD regimen) in newly diagnosed idiopathic Multicentric Castleman's disease (iMCD) patients.
This will be a single center, open-labeled, single arm, phase-II pilot study. The treatment and the response evaluation phase will last from the time of enrollment up to 21 months (evaluation will be carried out every 3 months in the first 9 months and every 6 months from Month 9 to Month 21). The maintenance and follow-up phase to assess for progression of disease will last from 21 months to 45 months after enrollment (evaluation will be carried out every 12 months). The total study duration will be 4 years after the last patient starts study medication.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
30
-Bortezomib: 1.3mg/m2 subcutaneous injection on Day 1,8,15,22 every month for 9 months; And maintained with 1.3mg/m2 subcutaneous injection every two weeks from Month 9 to 21;
-Cyclophosphamide: (oral) 300mg/m2 on Day 1, 8, 15, 22 every month for 9 months;
Dexamethasone: (oral) 40mg on Day 1,8,15,22 every month for 9 months; and maintained with 20mg (oral) every two weeks from Month 9 to 21.
Peking Union Medical College Hospital
Beijing, Beijing Municipality, China
RECRUITINGOverall response
Overall response is composed by biochemical, lymph node and symptom response, is the primary outcome of this study. According to the CDCN response criteria, an overall CR (complete response) requires a complete biochemical, lymph node, and symptomatic response; and overall PR (partial response) requires nothing less than a PR across all categories, but not meeting criteria for CR; an overall SD (stable disease) requires no PD (progression disease) in any of the categories and not meeting the criteria for CR or PR; an overall PD occurs when any category has a PD.
Time frame: 12 months after the last patient begins study treatment.
Time to initial response
defined as the time to achieve the first PR or CR. This outcome can be further divided into time to initial overall response, time to initial symptomatic response, time to initial biochemical response, time to initial lymph node response
Time frame: 12 months after the last patient begins study treatment.
Time to best response
defined as the time to achieve the best response (either PR or CR). This outcome can be further divided into time to best overall response, time to best symptomatic response, time to best biochemical response, time to best lymph node response;
Time frame: 12 months after the last patient begins study treatment.
Progression-free survival (PFS)
defined as the time to disease PD
Time frame: 12 months after the last patient begins study treatment.
Overall survival (OS)
defined as the time to patients' death
Time frame: 12 months after the last patient begins study treatment.
Change in PHQ-9 score
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PHQ-9 score (Patient Health Questionnaire scale-9) is a nine-item self-administered instrument to assess depressive symptoms which incorporates the DSM-IV (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition) classification for major depressive disorder. Each item is scored 0 - 3, which results in a range of scores between 0 and 27. PHQ-9 scores are interpreted as follows: (1) score \<5, no depression; (2) score 5 - 9, mild depression; (3) score 10 - 14, moderate depression; (4) score 15 - 19, moderately severe depression; and (5) score 20 - 27,severe depression.
Time frame: From Day 1 of the BCD treatment until 12 months after the treatment
Change in hemoglobin level
hemoglobin with g/L as unit of measure
Time frame: From baseline until 12 months after the treatment
Change in IL-6 (interleukin-6)
IL-6 level with pg/ml as unit of measure
Time frame: From baseline until 12 months after the treatment
Change in CRP
CRP (c-reactive protein) level with mg/L as unit of measure
Time frame: From baseline until 12 months after the treatment
Change in ESR
ESR (eerythrocyte sedimentation rate) level with mm/h as unit of measure
Time frame: From baseline until 12 months after the treatment
Change in IgG level
IgG (immunoglobin G) level with g/L as unit of measure
Time frame: From baseline until 12 months after the treatment
Change in MCD-related overall symptom score
Change of MCD symptom scores. MCD symptom score (MCD disease related overall symptom score) is a 34-item score based on NCI-CTCAE (V4.0) adverse events. Each item is scored 0-5, which results in a range of scores between 0 and 170. More scores indicate more severe disease activity.
Time frame: From baseline until 12 months after the treatment
Number of participants with treatment-related adverse events as assessed by CTCAE v4.0 ( ≥1 grade)
Number of participants with treatment-related adverse events as assessed by CTCAE v4.0 (patients with grades ≥1 would be included)
Time frame: 12 months after the last patient begins study treatment.
Number of participants with treatment-related serious adverse events as assessed by CTCAE v4.0 ( ≥3 grade)
Number of participants with treatment-related serious adverse events as assessed by CTCAE v4.0 (patients with grades ≥3 would be included)
Time frame: 12 months after the last patient begins study treatment